Subscriber's review of benefits statement uncovers identity theft by illegal alien

When a Blue Care Network subscriber reviewed her Explanation of Benefit Payments statement and discovered something suspicious, she contacted Blue Care Network. The Explanation of Benefits statement she received had a stranger's name on it. A project manager investigated only to discover two subscribers with the same Social Security number in the our systems.

Upon further investigation, it was discovered that the other subscriber was an illegal alien who had a fake Social Security card with the subscriber's number, and fraudulent naturalization papers. They were excellent forgeries — good enough for the man to fool an employer and get a job. None the wiser, the company put him on its health care policy.

If the subscriber had not been diligent enough to review her Explanation of Benefits statement or had not called us to investigate why a stranger's name was on it, the man would have continued to use her Social Security number.

In January 2008, the man was charged with three counts of health care fraud, insurance fraud and insurance identity theft.

Members who suspect health care fraud are urged to call our Anti-Fraud Hotline at 1-800-482-3787, or report fraud through our website.

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